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With the increasing number of cancer patients in China, the lack of hospice communication between medical staff and cancer patients can easily cause doctor-patient conflicts. Facing the special group of cancer patients, by introducing the concept of hospice communication and comparing the current situation of hospice communication of cancer patients at home and abroad, this paper found the shortcomings of hospice communication between medical staff and cancer patients in China. This paper aimed to analyze the influencing factors of cancer patients’ hospice communication from three aspects of medical staff, cancer patients and social and cultural background, summarized the assessment tools and matters needing attention related to hospice communication, so as to provide reference for domestic medical staff to develop relevant tools for hospice communication with cancer patients, and help medical staff to implement more effective hospice communication with cancer patients in the context of tranquil care. It is also conducive to help patients open the topic of death from the perspective of doctors and build an open hospice communication environment that is more in line with national conditions of China.
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Objective:To investigate the expression of the B cell ectopic gene 2 (BTG2) in the pancreatic cancer tissue and analyze its relationship with the clinicopathological features and prognosis.Methods:46 pairs of pancreatic cancer tissues and corresponding adjacent tissues kept in paraffin in the pathology department, and 9 fresh pancreatic cancer tissues and corresponding adjacent tissues resected by surgery in Department of Pancreatic Surgery of Sinopharm Dongfeng General Hospital from June 2015 to December 2020 were collected. BTG2 gene expression in 46 pairs of pancreatic cancer tissues and corresponding adjacent tissues were detected by immunohistochemical staining, and high and low BTG2 expression groups were divided. BTG2 gene expression in 9 fresh pancreatic cancer tissues and corresponding adjacent tissues were detected by RT-PCR. The correlation between BTG2 protein expression level and clinicopathological features was analyzed. Furthermore, the survival curve and death risk curve were drawn using the Kaplan-Meier method, and the Cox regression hazards model was applied for the univariate and multivariate analysis of the factors affecting the prognosis of pancreatic cancer.Results:29 of 46 (63.04%) pancreatic cancer tissues had high BTG2 expression, and 38(82.61%) of corresponding adjacent tissues had high BTG2 expression; and BTG2 high expression rate of adjacent tissues was significantly higher than that of cancer tissues. Three out of 9 pancreatic cancer tissues were highly differentiated, and six cases had medium-and low differentiation. The BTG2 expression of highly differentiated pancreatic carcinoma was significantly higher than that of moderately and poorly differentiated carcinoma tissues [(0.66±0.07 vs 0.24±0.18); the expression level of adjacent tissues was significantly higher than that of cancer tissues (1.00±0.00 vs 0.38±0.30), and all differences were statistically significant (all P values <0.001). Low BTG2 expression in pancreatic cancer was associated with low tumor differentiation and vascular invasion (all P values <0.05), but was not correlated with tumor location, volume, lymph node metastasis, CA19-9 level and postoperative liver metastasis. The median survival of high BTG2 expression group was significantly longer than that of low BTG2 expression group (525 d vs 266 d, P<0.001). Among patients with survival time ≥300 d, the survival time was significantly higher in the high BTG2 expression group than in the BTG2 low expression group (616±135d vs 426±113 d), and the difference was statistically significant ( P<0.001). Among patients with survival time <300 d, there was no significant difference between BTG2 high and low expression group. The results of the univariate analysis showed that tumor differentiation degree, vascular invasion, BTG2 expression, CA19-9 levels, and postoperative liver metastasis were all associated with the prognosis of pancreatic cancer. The results of the multivariate analysis showed that BTG2 expression level ( HR=2.572, 95% CI1.140-5.802, P=0.023), vascular invasion ( HR=0.023, 95% CI0.072-0.572, P=0.003) and postoperative liver metastasis ( HR=0.240, 95% CI0.102-0.564, P<0.001) were independent risk factors affecting the prognosis of patients with pancreatic cancer. Conclusions:BTG2 expression in pancreatic cancer tissues was significantly lower than that in adjacent tissues, and its low expression was associated with strong aggressiveness, low differentiation degree and poor prognosis of pancreatic cancer. The effect of BTG2 on the prognosis in pancreatic cancer patients was mainly in the long term.
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We developed a high-efficiency microfluidic chip for extracting exosomes from human plasma. We collected peripheral blood from normal human, designed and fabricated a microfluidic chip based on nanoporous membrane and agarose gel electrophoresis to isolate exosomes. The extracted exosomes were characterized by transmission electron microscopy, nanosight and Western blotting, the morphology, concentration and particle size of exosomes were identified and analyzed. Meanwhile, we used ultracentrifugation and microfluidic chip to isolate exosomes separately. The particle size and concentration of the exosomes extracted by two methods were compared and analyzed, and their respective extraction efficiency was discussed. Finally, the expression level of miRNA-21 in exosomes was analyzed by RT-PCR. The microfluidic chip isolated (in 1 hour) high-purity exosomes with size ranging from 30-200 nm directly from human plasma, allowing downstream exosomal miRNA analysis. By comparing with ultracentrifugation, the isolation yield of microfluidic chip was 3.80 times higher than ultracentrifugation when the volume of plasma sample less than 100 μL. The optimized parameters for exosome isolation by gel electrophoresis microfluidic chip were: voltage: 100 V; concentration of agarose gel: 1.0%; flow rate of injection pump: 0.1 mL/h. The gel electrophoresis microfluidic chips could rapidly and efficiently isolate the exosomes, showing great potential in the research of exosomes and cancer biomarkers.
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Humans , Exosomes , MicroRNAs/genetics , Microfluidics , Plasma , UltracentrifugationABSTRACT
Lung cancer is a malignant tumor with high incidence and mortality in the world, which seriously threatens people's safety and health. Early diagnosis of lung cancer is the key part in the process of prevention and treatment of lung cancer. It can improve the survival of patients with lung cancer. Exosomes are closely related to the invasion and metastasis process of tumor, it plays an important role in the development of lung cancer. Biomarkers based on exosomes have become a powerful diagnostic tool of lung cancer. Exosomes are lipid bilayer vesicles with uniform size and diameter of 30 nm-200 nm secreted by cells. Exosomes contain different types of nucleic acids and proteins. These nucleic acids and proteins are derived from their parent cells (including parent cancer cells), which have a wide range of physiological functions, including immune regulation, intercellular communication and other physiological activities. Biomacromolecules in exosomes, such as single-stranded RNA, long noncoding RNA, microRNA, protein and lipids, which can provide valuable genetic information for early clinical diagnosis of lung cancer. This review described the origin, structural characteristics, extraction methods, biological characteristics of exosomes and the relationships of exosomes in the early diagnosis of lung cancer. .
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AIM:To explore the effects of neuraminidase 3 (NEU3) on the viability, invasion and apoptosis of human prostate cancer DU145 cells and the molecular mechanism.METHODS:The human prostate cancer DU145 cells were divided into blank control group and treatment group.The cells in treatment group were treated with either neuraminidase inhibitor DANA, or NEU3 small interfering RNA (siRNA) to knock down the expression of NEU3.The cell viability was measured by CCK-8 assay.The cell invasion ability was detected by Transwell assay.The effects of the treatments on the mRNA level of Bcl-2 were detected by q PCR.The effects of the treatments on the protein levels of matrix metalloproteinase 2 (MMP2) and apoptotic inhibitory protein Bcl-2 were determined by Western blot.Apoptosis of the cells was analyzed by flow cytometry.RESULTS:The protein level of NEU3 and the apoptotic rate in DANA group were not significantly different from those in blank control group.The viability of DANA-treated DU145 cells was increased, and the invasion ability, MMP2 protein level, and Bcl-2 mRNA and protein levels were all decreased in these cells, compared with blank control group.On the other hand, the levels of NEU3 protein and Bcl-2 mRNA and protein in NEU3 siRNA group were significantly decreased compared with blank control group, while the viability and apoptotic rate of the cells with NEU3 siRNA transfection were increased (P<0.05).However, the protein expression of MMP2 and the invasion ability of the cells were not significantly changed after NEU3 siRNA treatment.CONCLUSION:The inhibition of NEU3 in enzyme activity and expression decreases the viability, and enhances the apoptosis of human prostate cancer DU145 cells.However, it has no obvious effect on the invasion ability of DU145 cells.
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Objective: To assess the anti-inflammatory and immunomodulatory activities of schisandrin B in mice. Methods: Kun-ming mice were randomly divided into 6 groups: the blank control group, the model control group, the positive control group( dexam-ethasone hydrochloride 5 mg·kg-1,levamisole hydrochloride 30 mg·kg-1), schisandrin B low (100 mg·kg-1), medium (200 mg ·kg-1) and high (400 mg·kg-1) dose groups. The inflammatory mice were induced by xylene and the immunosuppressed mice were induced by cyclophosphamide. The ear edema experiment, carbon clearance experiment and serum hemolysin experiment were per-formed with the swelling rate, swelling inhibition rate, carbon clearance index, phagocytic index, half hemolytic value, spleen index and thymus index as the investigation factors. Results: High dose and medium dose schisandrin B groups had significant inhibitory effect on mice ear edema when compared with the model control group(P<0. 05);There were significant differences between the high dose group and the positive group and there were significant differences in clearance index and phayxyitc index between high dose group and low dose group(P<0. 05), and high dose schisandrin B group had increased clearance index and phagocytic index in low immune function mice when compared with the model control group (P<0.05). Schisandrin B significantly increased HC50in low immune function mice when compared with the model control group (P<0. 01). Schisandrin B significantly increased the spleen index and thy-mus index in low immune function mice when compared with the model control group ( P<0. 01,and in a dose-dependent manner. Conclusion: Schisandrin B has significant anti-inflammatory and immune function enhancing effects.
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Objective To investigate the expression of calcineurin 1 (RCAN1) regulator and calcineurin A (Ca-NA) in brain tissue of temporal lobe (TLE) epilepsy patients and pentylenetetrazol (PTZ)-induced rat model. Methods Cortical samples from 18 patients with temporal lobe epilepsy were collected as epilepsy group and corti-cal samples from 11 patients with brain trauma were used as control group. 30 SD rats were randomly divided into model control group (MC) and PTZ group. The expression of RCAN1 and CaNA in human brain cortex,rat cortex and rat hippocampus were detected by Western blot and Immunohistochemistry assay. The location analysis of RCAN1 was detected by immunofluorescence. Moreover,co-immunoprecipitation was used to test whether there was an interaction between RCAN1 and CaNA. Results RCAN1 mainly located in neuronal cytomembrane.The expres-sion of RCAN1 was down-regulated and expression of CaNA was up-regulated both in the epileptic patients and epi-leptic rats (P<0.01). RCAN1 interacted with CaNA. Conclusions Decreased expression of RCAN1 and increased expression of CaNA indicate that RCAN1 may be involved in the epileptogenesis by regulating CaNA.
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The bodies found in water are one of the most common types in forensic practice. The dis-covery site of the body is often not the drowning site. However, the determination of drowning site is vital for the identification of victim. Inorganic particles and planktons, such as granular impurities, diatoms and bacteria, are valuable markers for the diagnosis of drowning. By comparing the granular impurities and planktons in tissues and suspicious drowning mediums, the drowning site can be concluded based on their similarity of types and distribution, which has practical applied value. In this paper, the research progress on determination of drowning site is summarized to provide reference for the peers.
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Objective: To investigate the effect of irrational use of traditional Chinese patent medicines (CPM) on medication safety.Methods: The adverse drug reaction (ADR) reports on traditional CPM (including traditional Chinese medicine for injection) in our hospital during January 2013 to October 2016 were collected and analyzed retrospectively.After finding the corresponding prescriptions, the situation of irrational drug use in the reports including indications, usage and dosage, combination of traditional CPM, combination of Chinese and western medicines and course were analyzed, and the rate of irrational drug use was calculated.Results: A total of 217 reports were collected including 217 patients.The primary diseases ranked top three were cardio-cerebral vascular system diseases, digestive system diseases and respiratory system diseases.The cases involved 81 kinds of drugs, and among them, 37 cases were induced by Shenmai injection.The rate of irrational drug use associated with indications, usage and dosage, combination of traditional Chinese patent medicines, combination of Chinese and western medicines and course was 6.45% , 5.99% , 2.76% , 0.92% and 1.84% , respectively, and the total rate was 17.97% (39/217).Conclusion: The irrational drug use maybe one of the important factors related to ADR of CPM.According to syndrome differentiation, CPM should be used rationally, and pharmaceutical care should be strengthened to reduce the incidence of ADR.
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Objective To investigate the clinical effect of Kangfuxin liquid topical treatment for open wound of perianal abscess.MethodsEighty patients with open wound were treated with perianal abscess from June 2015 to June 2016.The patients were divided into two groups according to their treatment group.Patients were treated with conventional regimen, while 40 patients in the observation group were treated with routine regimen+rehabilitation solution;the experimental data were compared between the two groups.The two groups were observed and compared the wound healing time (d), granulation growth cycle (d) and healing rate (%);the two groups were observed and compared the incision pain, edema, anal bulge and other symptoms disappeared time;compared two groups of clinical curative effect and complication rate.ResultsThe clinical treatment effect of the observation group was better than that of the control group, the difference was statistically significant (P<0.05).ConclusionThe clinical effect of the treatment of open wound in patients with perianal abscess with conventional therapy+rehabilitation therapy is significant, and the wound healing time is short, which is widely used in the treatment of open wound of perianal abscess.
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Objective To evaluate the feasibility of using ultrasound-guided lumbosacral plexus block combined with nasopharyngeal airway in hip replacement in elderly patients with pulmonary and lumbar diseases.Methods Eighteen elderly patients who were diagnosed as having puhnonary and lumbar diseases before operation,aged 75-97 yr,with body mass index of 18-22 kg/m2,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,scheduled for elective unilateral total hip replacement,were enrolled in this study.Unilateral lumbosacral plexus block was performed under the guidance of ultrasound.After completion of block,mild sedation was carried out with propofol,nasopharyngeal airway was implanted,oxygen was inhaled by mask,and sedation was maintained with small doses of propofol during operation.Bispectral index value was maintained at 60-75 during operation.Mean arterial pressure and heart rate were recorded before block,at 15 min after completion of block,before implantation of nasopharyngeal airway and at 1 min after implantation of nasopharyngeal airway.The postoperative nasopharyngeal airway removal time,development of cognitive dysfunction within 7 days after operation and recurrent puhnonary complications and mortality within 30 days after operation were recorded.Results All the patients underwent operation successfully,and vital signs were stable during operation.Nasopharyngeal airway was removed within 5 min after the end of operation,recurrent pulmonary complications were not found,and no patients developed cognitive dysfunction within 7 days after operation.No patient died within 30 days after operation.Conclusion Ultrasound-guided lumbosacral plexus block combined with nasopharyngeal airway produces reliable efficacy and fewer complications when applied to hip replacement and is suitable for elderly patients with pulmonary and lumbar diseases.
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Objective:To optimize the extraction process of Shenqi Lixin capsules through pharmacodynamic evaluation combined with orthogonal experiments with multi-index comprehensive evaluation.Methods:The congestive heart failure(CHF) model was established by intraperitoneal injection of doxorubicin in rats,and the LVEDD,LVESD,FS and LVEF of CHF rats were used as the indicators to screen the extraction process of the samples (process A was with the whole decoction of herbs and process B was with heterophylla powder mixed with the other herbs after boiling).The single factor tests and orthogonal tests were used to optimize the extraction process by taking the contents of astragaloside and tanshinone ⅡA and the quality of the decocted material as the indices,and adding water amount,decocting times and duration as the influencing factors.Results:Pharmacodynamic experiments indicated that the improvement effects of the samples from process B on cardiac symptoms and cardiac function in CHF rats were better than that of the samples from process A.The other medicinal materials were decocted by 12-fold amount of adding water,and repeated for 12 times with one hour for each time.The average extraction rate of astragaloside and tanshinone ⅡA was 61.82% and 50.07%,respectively,which was proven by the verification experiments.The average weight of the decoction was 6.02 g.Conclusion:The optimized extraction process of Shenq Lixin capsules is scientific,reasonable,stable and reliable.
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<p><b>OBJECTIVE</b>To investigate the effect of vildagliptin on pentamethazol (PTZ)-induced epilepsy in rats and explore the molecular mechanism.</p><p><b>METHODS</b>Samples of temporal cortex from 23 patients with temporal lobe epilepsy were collected as epilepsy group and samples of temporal cortex from 14 patients with brain trauma were used as control group. Ninety male SD rats were randomly divided into control group (group A), PTZ-induced epilepsy group (group B), saline 2 mL/kg group (group C), vildagliptin 2.5 mg/kg group (group D), vildagliptin 5mg/kg group (group D) and vildagliptin 10 mg/kg group (group F). Use chronic model of epilepsy induced by PTZ (35 mg/kg) intraperitoneal injection for 3 consecutive weeks, and changes of behavior were observed. The expression of GLP-1R was detected by Western blotting and immunohistochemical (IHC) staining, and the expression of GLP-1 was detected by enzyme-linked immunosorbent assay (ELISA). The location of GLP-1R was detected by immunofluorescent staining.</p><p><b>RESULTS</b>Immunofluorescent staining showed that the GLP-1R located in the neurons, and GLP-1R expression was obviously decreased both in patients with TLE and in rats with epilepsy. The latency time was prolonged and epilepsy attack time was decreased after vildagliptin treatment (P<0.05). GLP-1R expression was increased after vildagliptin treatment (P<0.05). ELISA showed the change of GLP-1 expression was the same as GLP-1R.</p><p><b>CONCLUSION</b>Vildagliptin can suppress temporal lobe epilepsy in rats by up-regulating GLP-1 and GLP-1R expressions.</p>
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The constituents of Cimicifuga plants have been extensively investigated, and the principal metabolites are 9, 19-cyclolanostane triterpenoid glycosides, which often exhibit extensive pharmacological activities. 9, 19-Cyclolanostane triterpenoid glycosides are distributed widely in genus Cimicifuga rather than in other members of the Ranunculaceae family. So far, more than 140 cycloartane triterpene glycosides have been isolated from Cimicifuga spp.. The aim of this review was to summarize all 9, 19-cyclolanostane triterpenoid glycosides based on the available relevant scientific literatures from 2000 to 2014. Biological studies of cycloartane triterpene glycosides from Cimicifuga spp. are also discussed.
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Animals , Humans , Cimicifuga , Chemistry , Drugs, Chinese Herbal , Chemistry , Pharmacology , Glycosides , Chemistry , Pharmacology , Photochemistry , Triterpenes , Chemistry , PharmacologyABSTRACT
Objective To evaluate the effects of long?term glucocorticoid administration on cisatra?curium?induced neuromuscular blockade in the patients undergoing laparoscopic operation. Methods Six?ty?four patients of both sexes, aged 40-64 yr, with body mass index of 18-22 kg∕m2 , of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, scheduled for elective laparoscopic operation under general anesthesia, were assigned into 4 groups ( n=16 each) according to whether or not glucocorticoid was used for a long?term period: control ( non?hormone and non?laparoscopic operation ) group ( group C ) , hor?mone + laparoscopic operation group ( group HL ) , non?hormone + laparoscopic operation group ( group NHL) and hormone +non?laparoscopic operation group ( group HNL) . Midazolam 0.03 mg∕kg was injected intravenously, 8% sevoflurane was inhaled by mask, and the concentration of sevoflurane was decreased by 2% every 30 s until the concentration of 4% was reached. After loss of eyelash reflex, remifentanil 2μg∕kg was injected intravenously over 1 min, and 30 s later sevoflurane inhalation was stopped. The patients were tracheally intubated and mechanically ventilated. Anesthesia was maintained with propofol and remifentanil given by target?controlled infusion. Neuromuscular blockade was monitored with accelerograph TOF?watch SX. At 20 min of pneumoperitoneum in NHL and HL groups or 20 min after intubation in C and HNL groups, cisatracurium 0. 15 mg∕kg was injected intravenously. The onset time, maximal degree of N?M block, clinical duration and recovery index of cisatracurium were recorded. Results Compared with group C, the onset time was significantly prolonged, the maximal degree of N?M block was decreased, the clini?cal duration was shortened, and the recovery index was decreased in HL and HNL groups ( P0.05) . Compared with group HNL, the clin?ical duration was significantly prolonged, the recovery index was increased (P0.05) , and the onset time was significantly shortened, the clinical duration was prolonged, and the recovery index was increased in group NHL ( P<0.05) . Com?pared with group NHL, the onset time was significantly prolonged, the maximal degree of N?M block was decreased, the clinical duration was shortened, and the recovery index was decreased in group HL ( P<0.05) . Conclusion Long?term glucocorticoid administration can weaken cisatracurium?induced neuromus?cular blockade in the patients undergoing laparoscopic operation.
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Objective To determine ED50 and ED9 5 of etomidate for combined remifentanil used in elderly patients in gastroscope.Methods Twenty-three patients were scheduled to receive gastros-copy aged 65-78 years old including males 13 and females 10,weighting 45-76 kg and ASA Ⅰ-Ⅲ. They were slowly injected remifentanil 0.3 μg/kg,and then etomidate 0.20 mg/kg,gastroscopy was performed after their eyelash reflex disappeared.The dosage of etomidate were determined by modified up-and-down methods,0.20 mg/kg was initial dosage.During the gastroscope,restlessness, frowning,swallowing,choking cough could be seen.The adjacent experimental interval dosage was 0.05 mg/kg,the trial was ended when there was the seventh cross-sectional,and determined the ED50 and ED9 5 of etomidate and (95%confidence interval)of them for gastroscope with probability a-nalysis methods.Results The ED50 of etomidate was 0.1 7 mg/kg and 95%CI 0.14-0.21 mg/kg,and the ED9 5 was 0.23 mg/kg,95%CI 0.20-0.42 mg/kg respectively.Conclusion The ED50 and ED9 5 of etomidate combined with remifentanil used for elderly patients for gastroscope respectively are 0.1 7 mg/kg and 0.23 mg/kg.
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Objective To investigate the effects of different doses of sufentanil on the minimum alveolar concentration (MAC) of sevoflurane for sedation in patients undergoing bronchoscopy. Methods ASA physical status I orⅡpatients of both genders, aged 20 ~ 65, undergoing bronchoscopy under general anesthesia,were randomly divided into 4 groups (n=20 each):control group (group C) and different doses of sufentanil groups (Sl, S2 and S3 groups). Sufentanil 0.1, 0.2 and 0.3 μg/kg in 5 mL of normal saline was intravenously infused before induction of anesthesia in groups of SI S2 and S3 respectively. While 5 mL of the normal saline was given instead in the group C The patients were mechanically ventilated after insert laryngeal mask. Anesthesia was maintained with inhalation of sevoflurane. Each time the concentration of sevoflurane at end expiration increased/decreased in the next patient depending on the concentration of sevoflurane at end expiration with which the former had no cough. The ratio between the two consecutive concentrations was 1.1. The middle point between the positive response and negative response served as a crossover pair. After at least 7 independent crossover pairs were observed in each group. The MAC and 95%confidence interval of sevoflurane were calculated. The time of anesthesia induction and analepsis was recorded. Results The MAC (95%CI) of sevoflurane was 3.0%(2.8%~3.3%), 2.3%(2.1%~2.5%), 1.9%(1.6% ~ 2.2%) and 1.6% (1.3% ~ 1.9%) in groups of C, S1, S2 and S3 respectively. The MAC of sevoflurane was significantly lower in groups of S1, S2, S3 than in the group C, and in groups S3 than in the group S1 (P<0.05). The time of anesthesia induction was significantly shorter in groups of S2, S3 than in the group C and significantly longer in groups S3 than in the group C. Conclusion Sufentanil of 0.1, 0.2, 0.3 μg/kg can significantly decrease the MAC of sevoflurane in patients undergoing bronchoscopy in a dose-dependent manner.
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OBJECTIVE:To provide reference for developing the antibiotic community pharmaceutical care. METHODS:Some residents of Jiangbei district of Ningbo were randomly collected for questionnaire survey on antibiotic storage,usage,accep-tance degree and demand of pharmaceutical care,etc. And the results were analyzed statistically. RESULTS:Totally 2 000 ques-tionnaires were sent out,1 784 were effectively received with effective rate of 89.2%. 74.2% of respondents had kept antibiotics in house;61.3% lacked antibiotic knowledge and easily be confused with anti-inflammatory drugs,43.5% thought antibiotics was ef-fective for virus infections;48.4% had self-treated with antibiotics,the most common reason was cold symptoms,and it existed amount or course of antibiotics changes by themselves;only 15.1%of them had knew or heard of pharmaceutical care;majority re-spondents(88.9%)wanted to accept antibotic pharmaceutical care,hoping to learn the indications,usage and dosage,contraindica-tions,precautions and adverse reactions of antibiotics by drug consultation,lecture,etc. CONCLUSIONS:The residents lack the knowledge about rational use of antibiotics,it is urgent for pharmacists to provide antibiotic community pharmaceutical care for resi-dents with purpose,which are important guarantee for rational use of antibiotics.
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Objective To investigate the effects of long-term glucocorticoid administration on neuromuscular block of cisatracurium in elderly patients undergoing general anesthesia. Methods Forty ASA Ⅱ or Ⅲ patients,aged≥65 yr,with BMI of 18-24 kg/m2 ,scheduled for elec-tive operation were studied.According to the history of using or not long-term glucocorticoid,patients were assigned into two groups (n = 20 each):control group(group C),glucocorticoid group(group J).Midazolam 0.03 mg/kg was injected,mask inhalation of 8% sevoflurane and flow rate of oxygen 8L,every 30 s decline 2%,until the 4%.After the disappearance of eyelash reflex,cisatracurium 0.1 5 mg/kg was injected intravenously.After 1 min intravenous injection of remifentanil 2 g/kg and 30 s after stop of sevoflurane inhalation anesthesia, endotracheal intubation for mechanical ventilation,target controlled infusion of propofol and remifentanil anesthesia,using TOF-Watch SX acceleromyography monitoring of muscle relaxation,and onset time,clinical duration and recovery in-dex(for T1 to return from 25% to 75% of the control twitch)were recorded.Results Compared with group C,the onset time was significantly prolonged,clinical duration and recovery index were short-ened in group J (P <0.05 ).Conclusion Long-term glucocorticoid admininstration could reduce the neuromuscular blocking effect of cisatracurium in elderly patients.
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Sialic acids are a subset of nine-carbon alpha-keto aldonic acids involved in various biological functions. Sialic acid on the sperm surface is closely related to sperm maturation and capacitation and sperm-egg recognition, which makes sperm negatively charged to avoid accumulation and covers some antigenic determinants there to increase the survival rate of sperm in the female reproductive tract. The loss of sialic acids is an important factor mediating sperm capacitation. Moreover, the sialic acid at the extremity of the protein polymer is involved in signal identification in sperm-egg recognition. Here, we review the current understanding of sialic acids in sperm maturation and capacitation and sperm-egg recognition.